Gastrointestinal: Endoscopic findings of collagenous gastroenterocolitis with protein‐losing enteropathy

Kochi, Shuji; Kurahara, Koichi; Matsumoto, Takayuki; Kawasaki, Keisuke; Oshiro, Yumi; Tokumoto, Masanori; Saka, Akiko; Fuchigami, Takeshi

doi:10.1111/jgh.12896

Cited by 4 publications

(3 citation statements)

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“…In some cases, we were able to further confirm the location of lymphatic leak via endoscopic visualization. In previous studies, endoscopic findings via EGD, video capsule, and enteroscopy have supported the paradigm that PLE is a diffuse disorder (6,14–16). Mucosal congestion with and without dilated lacteals has been documented in lymphatic flow disorders, including patients with PLE due to Fontan physiology (17,18).…”

Section: Discussionmentioning

confidence: 80%

Dynamic Contrast Magnetic Resonance Lymphangiography Localizes Lymphatic Leak to the Duodenum in Protein‐Losing Enteropathy

Brownell¹,

Biko²,

Mamula³

et al. 2021

J. pediatr. gastroenterol. nutr.

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Objectives: Protein-losing enteropathy (PLE) is a disorder of intestinal lymphatic flow resulting in leakage of protein-rich lymph into the gut lumen. Our primary aim was to report the imaging findings of dynamic contrast magnetic resonance lymphangiography (DCMRL) in patients with PLE. Our secondary objective was to use these imaging findings to characterize lymphatic phenotypes. Methods: Single-center retrospective cohort study of patients with PLE unrelated to single-ventricle circulation who underwent DCMRL. We report imaging findings of intranodal (IN), intrahepatic (IH), and intramesenteric (IM) access points for DCMRL. Results: Nineteen patients 0.3-58 years of age (median 1.2 years) underwent 29 DCMRL studies. Primary intestinal lymphangiectasia (PIL) was the most common referring diagnosis (42%). Other etiologies included constrictive pericarditis, thoracic insufficiency syndrome, and genetic disorders. IN-DCMRL demonstrated a normal central lymphatic system in all patients with an intact thoracic duct and localized duodenal leak in one patient (1/19, 5%). IH-DCMRL detected a duodenal leak in 12 of 17 (71%), and IM-DCMRL detected duodenal leak in 5 of 6 (83%). Independent of etiology, lymphatic leak was only visualized in the duodenum. Conclusions: In patients with PLE, imaging via DCMRL reveals that leak is localized to the duodenum regardless of etiology. Comprehensive imaging evaluation with three access points can provide detailed information about the site of duodenal leak.

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Section: Discussionmentioning

confidence: 80%

Dynamic Contrast Magnetic Resonance Lymphangiography Localizes Lymphatic Leak to the Duodenum in Protein‐Losing Enteropathy

Brownell¹,

Biko²,

Mamula³

et al. 2021

J. pediatr. gastroenterol. nutr.

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“…39,40 The term 'lymphocytic gastritis' was initially used to describe the histological counterpart to the endoscopic appearance of 'varioliform gastritis' characterised by nodules, thickened folds, and summit erosions, thereby mimicking the pustules of smallpox, with which the authors must therefore have been familiar. 39 Nonetheless, this association is rare, despite statements that it is present in 3.9%-30% of cases. 41 Up to half of cases of LG have no known association.…”

Section: Lymphocytic Gastritismentioning

confidence: 99%

“…LG is a chronic gastritis with an excess of intraepithelial lymphocytes (IELs), defined as >25 IELs/100 epithelial cells (one IEL/four epithelial cells), this being considered to be the upper limit of normal 39,40 . The term ‘lymphocytic gastritis’ was initially used to describe the histological counterpart to the endoscopic appearance of ‘varioliform gastritis’ characterised by nodules, thickened folds, and summit erosions, thereby mimicking the pustules of smallpox, with which the authors must therefore have been familiar 39 . Nonetheless, this association is rare, despite statements that it is present in 3.9%–30% of cases 41 .…”

Section: Lymphocytic Gastritismentioning

confidence: 99%

Beyond Helicobacter: dealing with other variants of gastritis—an algorithmic approach

El‐Zimaity

Riddell

2020

Histopathology

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In daily practice, the presence of inflammation in gastric biopsies prompts a mental algorithm, an early question being whether the lesion present is Helicobacter‐associated. If Helicobacter organisms are not found, then there is a further algorithm, governed by the predominant type of inflammatory cells present, and the presence of other features such as intraepithelial lymphocytosis, a subepithelial collagen band, granulomas, coexisting chronic inflammation, focality, and superimposed reactive changes including erosions and ulcers. Each of these generates its own differential diagnosis. If no inflammation is present, then the two major changes specifically looked for are the changes associated with hypergastrinaemia, by far the most common cause of which is treatment with proton pump inhibitors, and reactive changes. These may be present with and without accompanying inflammation, and, when the epithelial changes dominate, the term gastropathy is preferred. In this article, we present an approach to non‐Helicobacter inflammation and gastropathies.

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Endoscopic findings and colonic perforation in microscopic colitis: A systematic review

Marlicz

Skonieczna-Żydecka

Yung

et al. 2017

Digestive and Liver Disease

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Gastrointestinal: Endoscopic findings of collagenous gastroenterocolitis with protein‐losing enteropathy

Cited by 4 publications

References 0 publications

Dynamic Contrast Magnetic Resonance Lymphangiography Localizes Lymphatic Leak to the Duodenum in Protein‐Losing Enteropathy

Dynamic Contrast Magnetic Resonance Lymphangiography Localizes Lymphatic Leak to the Duodenum in Protein‐Losing Enteropathy

Beyond Helicobacter: dealing with other variants of gastritis—an algorithmic approach

Endoscopic findings and colonic perforation in microscopic colitis: A systematic review

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